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HomeMy WebLinkAboutVERNON LT 7A Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: C~l~[,d~'~ PIDNumber: O/~- ~-- Name: Wastewater System: ~ New ~ Upgrade Address: ~¢~ ~ 7~ /~ ABSORPTION FIELD Phone: ~No. of B~rooms: ~ Deep Trench ~ Shallow Trench ~Bed DMound DOther Total Depth from original grade: LEGAL DESCRIPTION Soil Rating: O ~, ~ GPD/Sq. Ft. /~ ~ Lot: Block: Subdivision: Depth to pipe bottom fr0m o[igin~ grade: Gravel depth beneath pipe Classificalion (Private, A,B,C): Total Depth: [ Cased To: Total absorption area: Pipe material: Drifter: Date Drilled: StaticWater Level: Installer: . O[ ~ ~ ~ Date installed~j j Yield: Casing Height Above Ground: SEPARATION DISTANCES ~s~t~ ~ ~o~n~ ~ From Tank Field Station Tank Sewer Lines &N C['~ ~A~JC Well J¢ '~ J ~ ( Material: ~ ~.~ Number of Compartments: Surface w.t~, N~:~ N~ LIFT STATION Lot Size in gallons: J Manufacturer: I Cu"ain Drain ~ ~J~ Pump Make & U°del Remarks: BENCH MARK , EN~N~'.~ SEAL Inspections performed by: ~ -~ Dates: 1st P~/5/ ;~ °¢~e::"~:*~-:~'~ Department of Health and Human Serwces approval ~, ~/% ~-~ ,*,::~/ Reviewed and approved by:/~ ~¢ Dato: /¢¢,R / , ~;~;~3~¢;¢ 72~013 (1/91) MOA 25 N 168 PL/£CUP[/VE T/~A£/_ TBBBEN SPURKLAND P.E. 6751 W. DIMDND BLVD. ANCH. AK. 99508-3904 L£T 7A VERNON S/D SECTI/~N $3 TI2N CI~RT PHALP SEPTZC SYSTEkl AS I~UILT DATE, SEPT, SO 1991 :S:HEE T~ 2/~ GR~D~ ~ Monitor 5 4O Monitor ~ Cover 103,5 9B. 4 Mimo£1 140 6 inches o£ Septic Rock ~BTTOH ~F TE£TH£LE Moni~om ~, ~ 0 £xis~, 5round 4' Min Cover TDBBEN SPURKLAND P,E, 203 ~ 15TH, AVENUE ANCH, AK, 99501 L 77 7A VE£NDN SEC?I[TN 33 ?]SN ~3~/ CDNT PHALP SEPTIC SYSTEM AS ~U]LT ~ATE, £EPF 30 1991 SHEET, ~/3 GRID, 2124 203 ~EST i§T~, AVENUE SUITE 206 ANCHORAGE, ~LASKA 99502-3904 (907) 27%3716 Susan Oswald Municipalit. y o-F Anchorage Division of Environmental Health Department o.F Health and Social Services 820 L Street Anchorage, Alaska 99501 October' 24, 199t Sub j ect: Permit ~ 910912 Lot 7 Vernon As Bui 1 t ! carl not explain why the test hole location on the permit appli- cation are where the are shown. I used the Highway Right of Way Map tm locate the holes~ and my swingties locate the holes on t. he north part o~ the lot,. The septic system was installed more or lese en top of the monitor tube~ so the location shown on the As Built is correct. The problem may be that the Highway ~ence was not installed along as designed~ or that t located the ~ence ir~correc:tly~ ££g66 '5tV 'UWA,I'FI :~'I'DV.W 'ldoCl u'[ ~_~--O~l ...... :shut. ii.do :10 Dulg~o ~o don~ xolO* pue PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910192 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:DALCOR INC OWNER ADDRESS:1201 EAST 70TH AVENUE ANCHORAGE, ALASKA 99518 DATE ISSUED: 7/12/91 EXPIRATION DATE: 7/12/92 PARCEL ID:01829271 LEGAL DESCRIPTION: VERNON LT 7A LOT SIZE: 64182 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ANCHORAGE, ALARKA 79~02-~04 (907) 248-5095 SEPTIC SYSTEM DESIGN LOT DelCor (-]round Water at 15 'Ft. Use Pressur'ized Bed Soil Rating. From test June 20~ 1991 8 min/in = .8 gal/ft day Required Bed Area SYSTEll Area per' Bedroom: 150/.8 = 187.5 Bedrooms 4 750 BED 20 x 40 x 5 ~ ROCK DEPTH .5 FT.~' COVER 4.5 FT.~.~ SEPTIC TANK 1500 GAL. STEP The installation o-{: this well and septic system will not impact adjacent lots. The well locatic~n con-Forms t.o the siting o~ the existing wells in the area~ and will not prevent the adjacent lot owners Yr'om dave]loping t. hese lot. s of replacing the existing The iristallalzic)e e¥ this septic system will nc:t prevent wells Yrc~m be installed on the adjacent lots. Septic System Design £._c:t 7A Vernon pg.1 The prl~pc~s~d septic system will n(:~t change the general slope o~ the area, Ponding and/c3r concentra'[~ion o.~ surface runo.~ will not result -~:rom this installati(~n, Sept. ic System Design Lclt 7A Vernon S/D p g. 2 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 6 7 8 9 10 11 13- 14- 15- 16- 17- 18- 19 2O COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG t PERCOLATION TEST EAL) DATE-- ~E~iFORb~ED¥ ~Township, Range, Section: WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth t0 Water ADer Monitorino? Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ ,~J;:~ (minutes/inch) PERC HOLE DIAMETER _ TEST RUN BE~WEEN ¢ FTAND V~" FT ACCORDANCE WITH ALL S'fATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DA]E: 72-008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: LoT 7,/~t 8 9 10-- 11 12 13 14 15 16 17 18 19 2O COMMENTS Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? giLT IF YES, AT WHAT Iq L._ DEPT.? ~ e I Monitorino? I~) Oale: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (4~ (minutes/inch) PERC HOLE DIAMETER L~ I ~ TEST RUN BETWEEN L~ FT AND /-7/Y~_~FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4~85) /15 I '1 N 4~ ' oF' Sep~,,c fe~,'_k ....... SPECIFICATIONS FOR SEPTIC SYSTEM INSTALLATI'ON LOT 7A VERNON SEC 55 T12N RSW t.0 GENERAL Owner is Cor'i: Phalp~ 1201 E 70th. 99518. F'hone: 344 .... ].,2 Enginemr is the person c~r enti'ky hired by i:he O~ner to inspect this project. The Engineer must be recognized by the Municipality o~ Anc:herage~ Department o~ Health and Human 1.5 Contractor is the person er entity hired by the Owner '~:e install this pr(:~ject. The Centractor must be recognized by the Municipality o'F Anch~)rage.~ Department. e-~ Health arid Human Services. 1.4 The Dra~,~ings~ sheets i through 3~ shall be part e~ this speci~:icatien. 1.5 Al:[ mater:i, aIe and workmansh:ip shall meet the require- merits o.~: the Munic:ipaii'~y e'F Anchorage~ Department o~ Health and [luman Services~ the conditions e~ the per"mit~ arid all applicable rules and regulatiens currently in e~:¥ec:t. :L.6 AIl. excavat, ic:~r] dept. hs are advisary~ and are t,o be veri~:ied and may be modified in the ~ield by the Engineer. 1.7 It is the resperlsibility o'F the Owner er' the Contractor to adhere te the approved design, te veri~y that the speci- fied ~-~eparation distances are met~ and that the required 1.8 The Con'~racter or' the Owner shall report 'bo the Engi- neer any observed conditien which would put t. he eeptic system in vielatien (:)~ State or Municipal regulatiens. 2.0 SEPTIC TANK 2.]. I¥ there is an e>[:i.s'[::i, ng sept.:i.c: tank~ i~ may be used :i~ t. ank shaii be irlspected by t. he Engineer,~ arid ii:s water" ti(..]htness and r~'[:ructur"al integrity shall be veri~CJ.~.~d. 2.2 A ne~,~ septic tank shall be one ~abricated by either Anchorage Tank and Welding er by Greet Tank Speci~:ic:ations ~or sept:[c system installation L. ot. 7A Vernon S/D pg. I The septic tank shall be a 'UPC-appr(~ved twc~-compartment tank~ c:onstrL~cted o~: 12 gauge~ or better~ steel with bitu mastic coating. The tank shall be set level ~n undisturbed soil.The tank shall be coverecl with the equivalent o~ ~our ~:eet c~-~ soil. 2.3 The septic tank shall be installed a minimum of five · f:eet Yrom the h(~use .~:<~undation and a minimum ~.F {:ive Yeet frc)m the absorption area. 2.4. The sept:Lc tank shall be a minimum o'~ 100 feet from any ~ell serving a single residence; ~00 feet 'From any body o'F wa'Ler~ creeks or drainage ditches wi'th flowing water; 150 ~eet ~rom Class "C" we].Is~ and 200 '~eet ~rom Class A or Class B wells. 2.5 All pipe connec'~.iens t~3 '~he tank shall be mechanical watertight calder couplings. Cleanouts shall be installed as des:i, gnated and capped with air-tight rain caps. Clean.- outs shall extend a minimum o.~ 12 inches abc)ye ~:inal gr'c~und elevat:i, or'~, Prc~visions sha].l be made for landscaping and impc]rtat:[on i'f: tc~pso:i.l. 2.6 An eYfluen'[ pump syst. em shall be installed, either in the septic tank or in a separate lift station tank. The requirements o'F the Health department. 3.0 ABSORPTION FIELD 3. :1. Gravel used in the absorption Yield shall be 0.5 to 2.5 inch screened r~ck, with less than 3% passing the Nc). 200 3.2 Sand, used ¥or leveling or for f:i. ltering~ shall have an e¥¥ective grain size between No,, 40 sieve and Nc]. 18 sieve. Uni.Formity i::oe.~:f:~cien'~ shall be le~.:,s than 4. Not more than 5% [)y ~eight shall pass the'Nc). 200 sieve. 3.3 4-incll per.l:or.a,[ed p:i. pe shall be ASTM F'SJ.C). For pres- sure distribution~ pipe shall be Sclnedule 40 PVC er ABS~ 3.4. Sc)lid 4..'-inch pipe shall be C'ast Iron er ASTM D3034. 3.5 Monitor stanclpipes shall be installed as shown. That sec'tion e'F t. he p:i.l:~m penetrating the gravel shall be per¥o- rated~ either by drilling 0.5" holes on 6-inc:h (:enters ~r by joining a section (;'~ FS10 perfl:~ra'[ed pile to a solicl section o~: pipe. 3.6 Geo'~:e;.,'tile shall be M:ira-fi J. 40,, 2;.7 Insulati(an shall be extruded direct burial p¢)lystyrene. Dow Chemical S'tyro~(]am HI 4.0. Gpet::i.Fications .~:c)r septic Lot 7A Vernon S/D system installation pg.2 3.8 T(]psoit shall be a mi;.~ture o¥ 40-6(}% 20-30% sand and more that 20% silt. All measLired by velume. organic matter ~ quantities are 3.9 Grass seed ehail be Kentucky bluegrass. 4.0 INSTALLATION 4. 1 Lc)cate all underground u'L:i, lities ~ preperty 1 ines ~ Yuture driw:-~ways~ e~isting er proposed water wells~ water pends, and all other '~acilities requiring separation dis tances ~rmm the pr'<~pesed septic system. I~c~ti~y Owner or Engineer o¥ any observed pessible con~lict. 4.2 Stake alignment e¥ system with markers shewing the pretective d:i. etanees ~rem ~el]l.s and water bodies. 4.Z~ Establish an elevatic~n benchmark. This BM shall be easily ident:~fiable~ stable and permanent. An arbitrary elevatic~n aY 1()0 c:an be assigned. 4.,4 Install the tank as sh(]wn on the drawings. Record the inlet and c~utlet elevati(]ne o'F the tank. Tank shall be []l al:ed Ol"~ t. Jndi stur'l:]ed i]a'Ei ve E~:Ji 1 . 4.5 Excavate the al]serptimn ~:ie].d. Bettclm (~.~: e;.(cavation shal:L be level and sc:ari~ied. I~ s'ide~alls smears~ they ehall also be scarified. Record the elevation o.t: each c(~rner and the center peint e.F the bed. Censtruc~ien equipment shall n~t operate en the ~:loor o~ the excavation. Any material cempac:ted by t. he operat.:i, on ef the construction equipment ehall removed and replaced with uncc]mpacted materials,, 4.6 Place the. reck to the depth !specified. Do not contami- nate rock w:i. th natiw~ materials er spoils .From the ex(::awa .... tion. Level the r"ec:k sur,¢ace (.~ .... 1") befere installing the perYerated pipe. 4..7 Ii"letall the distribut:[en pipe. Selvent weld the joints. 4.8 (];over' i Ftsul ati en ~ tine clistribution pipe with roc:k, and cover the with geotextile before back¥illir~g and placing i'¢ required. 4.9 Record t. he ¥:i. nished greL{r]d elevation o~ each corner and the center o¥ the bed. 4.10 Furnish a copy (::)~ all survey ne'l;es 'ti] the Engineer. Speci~:i(::atiens -6or Let: 7A Vernon S/D septic system installation pg.3 5.0 INSPECTIONS 5. 1 A minimum e¥ 'L:lnree inspectieqe are required. The first inspec:tic]n will be o.~: the open excavation. At this time the soil conditions will be observed and compared to the design assumptions. Ground water conditions or preseoce o'F bech'-ock will be verified. The secood inspection will be a~ter placement o~ st:andp:i, pes~ d:i. etr'ibution piping~ tank(s) and other oente as specified. The t:h:[r'd inspectioo will be a~ter completion o~ the work. Any de~:icieociee will be noted and the Contractor netified. Such de¥iciencies shall be torres:ted within ten days. 5.2 All elec:trical work requires e:it. her an MOA electr'il--al :L nspec:t i on or cer'ti f ic:ation by an licensed ~.~1 ectrici an. Submi'[ proo-~ o¥ inspection or certification to the Engineer. 5.3 Submit catalog data o.F all mechanical equipment. 5.4. Nc)'[iYy Engineer at leas'[ 24 hours in advance o~ begin- I'1i ng any wot k. Speci¥icatione ~or septic system installation Lot 7A Vernon S/D pg. 4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~.4~_ ~-'/I NAA# ~, .,~c~ ~. ~,/-~ 1. GENERAL INFORMATION Complete legal description Location (site.address or directions) Property owner Mailing address Lending agency Mailing address. Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Pubtic sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72*025 {Rev. 1/91) Front MOA #21 5, STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm '~0/¢/~.-~ ~! Phone Address Engineer's signature DHHS SIGNATURE ~/~/__ Approved for //'~4~'- ~.~/~/~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Legal Description: Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type ~' Log present (Y/N) y Total depth /~ / Sanitary seal (Y/N) ~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~'/3 '~' ~ / Driller Cased to ! ~ / Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level ~' Well flow pump level ~'~ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / G "7 AbSOrption field on lot / ~" ATINSPECTION ; On adjacent lots ; On adjacent lots //?- Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform f Date of sample: , z./~ 7~/~ / Nitrate Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria Th/Tr. B. SEPTIC/HOLDING TANK DATA Date installed ~//~/'t ( Cleanouts (Y/N) y High water alarm (Y/N) Date of pumping Tank size 1~,~0 Compartments Foundation cleanout (Y/N) ./~/' Depression (Y/N) [~//~- Alarm tested (Y/N) h/,/~ Pumper ~'~/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /~ 7 TO property line /~ ~ Surface water/drainage On adjacent lots .'~ /~ Foundation Absorption field ~ ''~ Water main/service line. 72-026 (Rev. 7/91) Front 't "' N. C'ONT NuED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manhole/Access (Y/N) . "Pump off" level at Cycles tested Meets MQA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length /'/O Width Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating ¢ Gravel thickness ¢ ¢?~¢f// System type z/. Total depth Cleanouts present (Y/N) Date of adequacy test for Z~./ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / ~ ~ On adjacent lots )/~ To building foundation ~' ~ On adjacent lots Surface water Curtain drain _ Property line Cutbank To existing or abandoned system on lot t~_ /dip Water main/service line Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the d~te of this inspection. Engineers Name Date 0///~ ~/~ ~?,~ HAA Fee $ Date of Payment Receipt Number 72-026 (Re¥. 3/91) Bsck MOA Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. ~633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS RESOLES for INVOICE t 4i291 Chemlab Ref.t 91.675i Sample t $ Matrix: MATER Client Sample ID : POTABLE L7A YERNON PMSID : UA Collected : DSC 23 91 @ 13:45 his. Received : DEC 23 91 @ 14:45 his. P~eserved with : AS REQUIRED Client Name :TOBBEN SPURKLAND. P.E. Client lout :TOBSENS ~POt : POt :NO~E RECEIVED Req! : Ozdered By : Analysis Completed : DEC 27 91 Labo[atory Supe~vlsq[ :,~TSPIt~N C. EDE Released By: ~ ~_ ~ Send Repozts to: I)TOEBEN SPI~A~. P.E. ~) Results Ur~ts Method lllo~able Limits NITgATE-N 2.2 mCJ/1 EPA 353.2 Sample ROll, INS SAMPL~ COLLECTED BY: T. SPURKLAtlD. Remarks: 1 Tests Performed * See Special Instructions Above UA-Unavailable }ID= Rone Detected '* See Sample Rama[ks Above NA- Not Analyzed LT-Less Then, OT-Oreater Than IP~,~ SGS Member of the SGS Group (Soci~t~ GCn~rale de Surveillance)